Audit Cases

91% bill reduction after audit for treatment of benign tumor and surgery

Comprehensive line-by-line claim auditing by healthcare professionals is used to uncover errors typically not caught. ClaimDOC publishes a sample of five recent client savings audit results bi-monthly. See the savings below and know that together we can make healthcare affordable.

1. Tampa, FL

Hospital outpatient services for the treatment of benign tumor of parathyroid gland and surgery

High-Dollar Services:

  • Operating Room: $38,409
  • Recovery Room: $11,439

Savings Summary:

  • Billed Charges: $67,738
  • ClaimDOC Allowed: $5,923.09
  • Plan Savings: $61,814.91
  • Reduction: 91%

2. Bradenton, FL

Fourteen-day hospital stay for the treatment of acute kidney failure and respiratory failure

  • Room and Board: $66,264
  • Pharmacy: $40,521
  • Laboratory: $36,935
  • CT Scan (2): $27,444
  • Billed Charges: $232,342
  • ClaimDOC Allowed: $27,808.95
  • Plan Savings: $204,533.05
  • Reduction: 88%
High-Dollar Services: Savings Summary:

3. Tallahassee, FL

Hospital outpatient services for the treatment of cervical cancer and radiation therapy treatments

  • Radiation Therapy Treatments (16): $67,179.84
  • Billed Charges: $85,174.42
  • ClaimDOC Allowed: $12,763.04
  • Plan Savings: $72,411.38
  • Reduction: 85%
High-Dollar Services: Savings Summary:

4. Erie, PA

Sixteen-day hospital stay for the treatment of endocarditis, respiratory failure and pneumonia

  • Room and Board: $91,745
  • Billed Charges: $188,406.90
  • ClaimDOC Allowed: $28,660.76
  • Plan Savings: $159,746.14
  • Reduction: 85%
High-Dollar Services: Savings Summary:

5. Columbus, IN

Ambulatory Surgical Center (ASC) services for the treatment of osteoarthritis of right knee/surgery

High-Dollar Services:

  • Surgery: $73,341

Savings Summary:

  • Billed Charges: $73,341
  • ClaimDOC Allowed: $11,534.64
  • Plan Savings: $61,806.36
  • Reduction: 84%

Disclaimer – The analysis of any medical billing or coding is dependent on numerous facts, regulations, payer policies, and codes, as well as the controlling plan description. The information contained herein is intended to provide a real-life example of opportunities for savings through ClaimDOC services but is not intended to provide medical, legal, or financial advice.